Basic Information
| Provider Information | |||||||||
| NPI: | 1396761805 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | OCHSNER BAYOU LLC | ||||||||
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| OtherOrganizationName: | OCHSNER ST. ANNE GENERAL HOSPITAL | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4608 HIGHWAY 1 | ||||||||
| Address2: | |||||||||
| City: | RACELAND | ||||||||
| State: | LA | ||||||||
| PostalCode: | 703942623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9858732200 | ||||||||
| FaxNumber: | 9858731262 | ||||||||
| Practice Location | |||||||||
| Address1: | 4608 HIGHWAY 1 | ||||||||
| Address2: | |||||||||
| City: | RACELAND | ||||||||
| State: | LA | ||||||||
| PostalCode: | 703942623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9858732200 | ||||||||
| FaxNumber: | 9858731262 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2006 | ||||||||
| LastUpdateDate: | 10/12/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | ALLEN | ||||||||
| AuthorizedOfficialFirstName: | TIMOTHY | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 9858731285 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 10/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 273R00000X | 594 | LA | N | Hospital Units | Psychiatric Unit | 282NC0060X | 594 | LA | Y | Hospitals | General Acute Care Hospital | Critical Access |
ID Information
| ID | Type | State | Issuer | Description | 1797430 | 05 | LA | MEDICAID | 61387 | 01 | LA | BLUE CROSS HOSPITAL PROV | OTHER | H4260 | 01 | LA | BLUE CROSS CRNA | OTHER | 61386 | 01 | LA | BLUE CROSS PSYCH | OTHER | H4245 | 01 | LA | BLUE CROSS ER PHY | OTHER | 1734357 | 05 | LA | MEDICAID |